摘要
下肢截肢虽已发现是心血管疾病的可能危险因素,但潜在的生物力学机制仍未得到充分了解。该研究的目的是了解术后不同时期和生活状态下肢截肢患者的心血管血流动力学状况,以评估异常血流动力学对心血管系统的影响。该文建立了含下肢动脉的心血管系统集中参数模型,模拟了截肢术后、术后成熟期和术后长期久坐三种常见的截肢患者状态。该文以7名下肢截肢患者超声实测下肢动脉直径为模型的参数设置参考。通过将正常人模型和下肢截肢模型的血压和血流量波形对比分析,发现截肢术后血管收缩压和舒张压幅值上升,腹主动脉及以下的动脉流量峰值明显下降;术后成熟期和长期久坐血压在舒张期早期峰值上升。这种异常的血流动力学变化可能是下肢截肢患者患高血压与心室肥大等心血管疾病的危险因素。该文建立的集中参数模型提供了截肢后血流动力学的变化规律,可为未来截肢患者康复治疗和心血管疾病预防提供理论指导。
Although lower limb amputation has been identified as a possible risk factor of cardiovascular disease,the underlying biomedical mechanisms are not completely understood.The purpose of this study was to examine the cardiovascular hemodynamic status of lower limb amputees at different postoperative periods and life status to evaluate the impact of abnormal hemodynamics on cardiovascular system.In this paper,a centralized parameter model of the cardiovascular system with lower limb arteries was established to simulate three common conditions of amputation patients,i.e.,postoperation,postoperation residual limb atrophy and postoperation both limb atrophy.The diameter of lower limb artery measured by ultrasound in 7 patients with lower limb amputation was used as the reference for parameter setting of the model.By comparing the blood pressure and blood flow waveform of the normal person model and the lower limb amputation model,we found that the amplitude of the systolic and diastolic blood pressure increased after amputation,and the peak value of the arterial flow in the abdominal aorta and below decreased significantly.In postoperation residual limb atrophy and postoperation both limb atrophy,the peak blood pressure in the central aorta increased during diastole.Such abnormal hemodynamic changes may be a risk factor of cardiovascular diseases such as hypertension and ventricular hypertrophy in lower limb amputees.The centralized parameter model established in this paper provides the change rule of hemodynamics after amputation,which can provide theoretical guidance of rehabilitation treatment and cardiovascular disease prevention of amputation patients in the future.
作者
刁珺杰
蒋文涛
李忠友
魏君如
李潇
闵磊
DIAO Jun-jie;JIANG Wen-tao;LI Zhong-you;WEI Jun-ru;LI Xiao;MIN Lei(Department of Mechanical Science and Engineering,Sichuan University,Chengdu 610065,China;Biomechanical Engineering Laboratory,Sichuan University,Chengdu 610065,China)
出处
《工程力学》
EI
CSCD
北大核心
2023年第4期233-242,共10页
Engineering Mechanics
基金
国家自然科学基金项目(11972239,1772210,12102281)
中国博士后面上项目(2021M702368)
中央高校基本科研业务费专项资金项目(2021SCU12128)。
关键词
下肢截肢
血流动力学
集中参数模型
心血管疾病
外周阻抗
lower limb amputation
hemodynamics
lumped parameter model
cardiovascular disease
peripheral impedance